Adherence to nutritional recommendations by patients undergoing cardiovascular rehabilitation: A randomized controlled trial.

BACKGROUND

Cardiovascular diseases are the leading cause of mortality worldwide. Nutritional counseling is a key component of cardiac rehabilitation (CR) but often faces challenges in patients' adherence, particularly in low-resource settings.

OBJECTIVES

To evaluate the adherence to nutritional recommendations among patients enrolled in a CR program and to assess the impact of individualized nutritional counseling on dietary intake.

DESIGN

Randomized controlled clinical trial.

METHODS

Outpatient CR clinic at the Hospital das clinicas of Universidade Federal de Minas Gerais. A total of 98 adults (mean age 60.4 ± 10.9 y; 57.1% male) with diagnosed cardiovascular conditions referred to CR randomly assigned to intervention (n = 46) or control (n = 52) groups. The intervention group received individualized dietary plans and monthly nutritional counseling over 4 mo, while the control group received standard care without nutritional guidance during the study period. The primary outcome was the adherence to nutritional recommendations based on analysis of 3-d dietary records (caloric intake, macronutrients, sodium, fiber). Adherence was defined as meeting or improving toward dietary recommendations.

RESULTS

At baseline, sodium intake showed the highest adherence (89.8%), and fiber intake the lowest (8.2%). After 4 mo, the intervention group had a significant increase in protein intake (P < 0.05) and a 27.5% higher adherence to protein recommendations compared to the control group (P = 0.008). No significant differences were observed for other nutrients.

CONCLUSIONS

Individualized nutritional counseling within CR programs improves adherence to dietary protein recommendations, emphasizing its importance in secondary prevention of cardiovascular disease. Integrating structured nutritional strategies into CR may enhance clinical outcomes and support comprehensive care.